Health inspection·October 13, 2023

F 0626 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to readmit one out of two sampled residents (Resident 1) from the General Acute Care Hospital 1 (GACH1) after the resident was cleared by GACH 1 to return to the facility on 9/14/2022. This deficient practice resulted in denial of Resident 1 ' s right to return to the facility where she lived. Findings: During a review of the facility census (daily official count and list of residents admitted to the facility) dated 10/13/2023, the census indicated 40 in house residents and 3 bed holds (if a resident is transferred out, the facility reserves the resident ' s bed for seven days) for residents not in the facility. During a review of Resident 1 ' s admission Record, the admission Record indicated Resident 1 was originally admitted on [DATE] and was readmitted on [DATE] with diagnoses including cerebral palsy (a condition that affects muscle tone, movement, and coordination that limit activity), dysphagia (difficulty swallowing), muscle weakness, diabetes mellitus (high blood sugar) and urinary tract infection. During a review of Resident 1's History and Physical (H&P), dated 7/29/2023, the H&P indicated Resident 1 does not have capacity to understand and make decisions. During a review of Resident 1's Minimum Data Set ([MDS] a standardized assessment and care-screening tool) dated 7/13/2023, the MDS indicated Resident 1's cognition (the ability to think, reason, and understand) was severely impaired. The MDS indicated Resident 1 was totaly dependant on two-person assistance for bed mobility, toileting, eating, dressing, and personal hygiene. During a review of Resident 1 ' s order summary dated 9/8/2023, the order summary note indicated Resident 1 had a seven-day bed hold, in place if Resident 1 were to be temporarily transferred out, and readmitted . During a review of Resident 1 ' s Physician ' s orders dated 9/30/2023, the order indicated to transfer Resident 1 to a GACH due to desaturation (abnormally low blood oxygen concentration). During a review of Resident 1 ' s general acute care hospital (GACH) ombudsman (public advocate) Page 1 of 2 056104 056104 10/13/2023 Rose Villa Health Care Center 9028 Rose Street Bellflower, CA 90706

F 0626 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few notification, dated 10/10/2023, the ombudsman notitification indicated the facility declined to take the resident back on 10/3/2023 because Resident 1 had Candida auris (C- auris: a type of yeast that can cause severe illness and spreads easily) and the facility stated they did not have an isolation room, and could not accomodate Resident 1. During an interview on 10/13/2023, at 12:35 pm, with the Director of Nursing (DON), the DON stated the facility could not readmit Resident 1 due to a C-auris diagnosis. The DON stated Resident 1's C-auris diagnosis required a dedicated room and staff to care for Resident 1 and the facility staff were not trained for this type of isolation. During an interview on 10/13/2023, at 12:45 p.m. with social worker (SW) of the GACH, the SW stated the skilled nursing facility informed her that they don ' t have an isolation bed, so they would not be taking the resident back. During an interview on 10/13/2023, at 1:35 pm, with the admission Coordinator (AC), the AC stated the facility cannot take residents on isolation for Candida auris , because the facility is not equipped for that. A resident with C-auris infection requires a lifetime isolation, and more attention than regular residents, if the residents are sharing rooms or bathrooms, we are exposing our other residents. According the Centers for disease control (CDC: Federal agency that supports the nation's health promotions, prevention and preparedness) if a skilled nursing facility has a resident positive for C-auris, the facility should place the resident on transmission based precautions (measures and tools used to prevent the spread of infections), ensure the appropriate use of gowns and gloves, performe hand hygiene, and the use of appropriate disinfectants. (https://www.cdc.gov/fungal/candida-auris/fact-sheets/cdc-message-infection-experts.html). During a review of the facility ' s policy and procedure (P/P) titled Bed Hold & Readmission revised on 1/2022, the P/P indicated If the resident's hospitalization or therapeutic leave exceeds the bed-hold period of 7 days, the resident may return to the facility to their previous room, if available, or immediately upon the first availability of a bed in a semi-private room, if the resident requires the services provided by the facility; and Is eligible for Medicare skilled nursing facility services or Medicaid nursing facility services. 056104 Page 2 of 2